Systems for Performing Endoscopic Procedures

ABSTRACT

A system for performing an endoscopic procedure is provided. The system includes an actuation assembly having a handle assembly and a shaft assembly. The system also includes an end effector configured for selective and operative connection to a distal end of the shaft assembly. The system further includes a holder for selectively engaging the end effector and facilitating attachment of the end effector to the shaft assembly.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.14/164,292 filed Jan. 27, 2014, which claims the benefit of and priorityto U.S. Provisional Patent Application No. 61/782,700, filed Mar. 14,2013, the entire disclosure of which is incorporated by referenceherein.

BACKGROUND Technical Field

The present disclosure relates to endoscopic surgery, and moreparticularly, to a system for performing endoscopic procedures.

Background of Related Art

Surgery often requires access to internal tissue through open surgicalprocedures or endoscopic surgical procedures. As used herein, the term“endoscopic” refers to all types of minimally invasive surgicalprocedures including laparoscopic, arthroscopic, natural orificeintraluminal, and natural orifice transluminal procedures. Endoscopicsurgery has numerous advantages compared to traditional open surgicalprocedures, including reduced scarring. Endoscopic surgery is oftenperformed in an insufflatory fluid present within the body cavity, suchas carbon dioxide or saline, to provide adequate space to perform theintended surgical procedures. The insufflated cavity is generally underpressure and is sometimes referred to as being in a state ofpneumoperitoneum. Surgical access devices are often used to facilitatesurgical manipulation of internal tissue while maintainingpneumoperitoneum. For example, trocars are often used to provide a portthrough which endoscopic surgical instruments are passed. Trocarsgenerally have an instrument seal, which prevents the insufflatory fluidfrom escaping while an instrument is positioned in the trocar.Alternatively, an instrument may be inserted directly through anopening, i.e., incision, in tissue into the body cavity.

The size of the instrument used during a endoscopic procedure is limitedby the size of port through which the endoscopic instruments areinserted. The larger a port, the larger the instrument that may beinserted therethrough, however, also the larger the resulting scar inthe tissue. To overcome the limitation in the size of the instrumentpresented by the size of the port, it would be beneficial to provide anendoscopic instrument having a distal shaft with a first cross-sectionalsize that may be received either directly through tissue, oralternatively, through an instrument port, and one or more end effectorshaving an enlarged cross-sectional size that may be introduced into acavity through an alternative means, i.e., a second larger instrumentport, and may be selectively attached to and disconnected from thedistal shaft within the body cavity.

SUMMARY

A system for performing an endoscopic procedure is provided. The systemincludes an actuation assembly having a handle assembly and a shaftassembly. The system also includes an end effector configured forselective and operative connection to a distal end of the shaftassembly. The system further includes a holder for selectively engagingthe end effector and facilitating attachment of the end effector to theshaft assembly.

Also provided is an instrument for performing endoscopic procedures. Theinstrument includes an actuation assembly having a handle assembly and ashaft assembly. The handle assembly includes a trigger mechanism, aslider mechanism, a drive mechanism, and a latch mechanism. The shaftassembly includes a connection mechanism, the connection assemblyincluding an outer tube, a center tube slideably disposed relative tothe outer tube, an inner tube slidably disposed relative to the outerand center tubes and a center rod slideably disposed relative to outer,center, and inner tubes. The instrument may further include an endeffector operably engaged with the connection mechanism. The endeffector may include a connection assembly and a jaw assembly. Theconnection assembly may include a tubular body having a pair of distalsupports extending distally therefrom for operable engagement with jawassembly. The jaw assembly may include a link member, a first jawmember, and a second jaw member.

In addition, a holder for facilitating attachment of an end effector toan actuation assembly is provided. The holder includes an outer tubedefining a longitudinal axis and an inner shaft slidably disposed withinthe outer tube. The inner shaft includes distally extending armsconfigured to be flexed inwardly upon engagement with the outer tube.The holder also includes a capsule pivotally mounted between thedistally extending arms. The capsule includes a substantiallycylindrical body configured for select reception of an end effector.Inward flexion of the arms of the inner shaft pivotally fixes thecapsule relative to the inner shaft.

Further provided is a kit for performing an endoscopic procedure. Thekit includes an actuation assembly for manipulating an end effectorduring an endoscopic procedure, a first end effector for performing afirst function, a second end effector for performing a second function,and a holder configured to selectively support the first and second endeffectors.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosureand, together with a general description of the disclosure given above,and the detailed description of the embodiment(s) given below, serve toexplain the principles of the disclosure, wherein:

FIG. 1 is a perspective view of the a endoscopic instrument according toan embodiment of the present disclosure;

FIG. 2 is an enlarged side view of a portion of an actuation assembly ofthe endoscopic instrument shown in FIG. 1, in a first or percutaneousposition;

FIG. 3 is a perspective first side view of the portion of the actuationassembly shown in FIG. 2, in the first or percutaneous position;

FIG. 4 is a perspective second side view of the portion of the actuationassembly shown in FIG. 2, in the first or percutaneous position;

FIG. 5 is an exploded perspective view of the actuation assembly shownin FIG. 2;

FIG. 6 is a perspective view of the distal end of a connection mechanismof the actuation assembly shown in FIG. 2 and an end effector of theendoscopic instrument shown in FIG. 1;

FIG. 7 is a cross-sectional view of the end effector shown in FIG. 6taken along line 7-7;

FIG. 8 is an exploded perspective view of the distal end of theconnection mechanism shown in FIG. 6;

FIG. 9 is an exploded perspective view of the end effector shown in FIG.6;

FIG. 10 is a cross-sectional view taken along line 10-10 shown in FIG.1;

FIG. 11 is an enlarged view of portion 11 shown in FIG. 10;

FIG. 12 is an enlarged view of portion 12 shown in FIG. 10;

FIG. 13 is an enlarged view of portion 13 shown in FIG. 5;

FIG. 14 is a cross-sectional view taken along line 14-14 shown in FIG.11;

FIG. 15 is a perspective view of the end effector and the distal end ofthe connection mechanism shown in FIG. 6, upon receipt of the distal endof the connection mechanism within the end effector shown in FIG. 6;

FIG. 16 is a cross-sectional view taken along 16-16 shown in FIG. 15;

FIG. 17 is a side view of the portion of the actuation assembly shown inFIG. 2, in a second or intermediate position;

FIG. 18 is a cross-sectional side view of the portion of the actuationassembly shown in FIG. 17;

FIG. 19 is an enlarged view of portion 19 shown in FIG. 18;

FIG. 20 is an enlarged view of portion 20 shown in FIG. 18;

FIG. 21 is a side view of the portion of the actuation assembly shown inFIG. 2, in a third or engaged position;

FIG. 22 is a cross-sectional view of the portion of the actuationassembly shown in FIG. 21;

FIG. 23 is an enlarged view of portion 23 shown in FIG. 22;

FIG. 24 is an enlarged view of portion 24 shown in FIG. 22;

FIG. 25 is a cross-sectional view taken along line 25-25 shown in FIG.23;

FIG. 26 is a perspective view of the endoscopic instrument shown in FIG.1, in an engaged position and with the jaw assembly of the end effectorin an open position;

FIG. 27 is an enlarged view of the jaw assembly shown in FIG. 26, in theopen position;

FIG. 28 is a cross-sectional view of the of endoscopic instrument asshown in FIG. 27;

FIG. 29 is an enlarged view of portion 23 shown in FIG. 28;

FIG. 30 is an enlarged view of portion 24 shown in FIG. 28;

FIG. 31 is a perspective view of an end effector and a distal end of aconnection mechanism according to another embodiment of the presentdisclosure, the end effector being received on the distal end of theconnection mechanism;

FIG. 32 is a perspective view of the end effector and the distal end ofthe connection mechanism of FIG. 31, the end effector being separatedfrom the distal end of the connection mechanism;

FIG. 33 is an enlarged cross-sectional view taken along line 33-33 shownin FIG. 32;

FIG. 34 is an exploded perspective view of the distal end of theconnection mechanism shown in FIG. 31;

FIG. 35 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 31, during a firststep of attaching the end effector to the connection mechanism;

FIG. 36 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 35, during asubsequent attachment step;

FIG. 37 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 35, during anotherattachment step;

FIG. 38 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 35, upon completeattachment of the end effector to the distal end of the connectionmechanism;

FIG. 39 is a perspective view of an end effector and a distal end of aconnection mechanism according to still another embodiment of thepresent disclosure, the end effector being received on the distal end ofthe connection mechanism;

FIG. 40 is a perspective view of the end effector and the distal end ofthe connection mechanism of FIG. 39, the end effector being separatedfrom the distal end of the connection mechanism;

FIG. 41 is a perspective view of the distal end of the connectionmechanism shown in FIG. 40, in a position ready for insertion into abody cavity of a patient;

FIG. 42 is a perspective view of the connection mechanism shown in FIG.40, in a position ready for connection with the end effector shown inFIG. 40;

FIG. 43 is a cross-sectional view taken along line 43-43 shown in FIG.42;

FIG. 44 is an enlarged exploded view of the distal end of the connectionmechanism shown in FIG. 43;

FIG. 45 is a perspective view of a link member of the end effector shownin FIG. 40;

FIG. 46 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 40, during a firststep of attaching the end effector to the connection mechanism;

FIG. 47 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 40, during asubsequent attachment step;

FIG. 48 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 40, upon completeattachment of the end effector to the distal end of the connectionmechanism;

FIG. 49 is a perspective view of an end effector and a distal end of aconnection mechanism according to yet another embodiment of the presentdisclosure, the end effector being received on the distal end of theconnection mechanism;

FIG. 50 is a perspective view of the end effector and the distal end ofthe connection mechanism of FIG. 49, the end effector being separatedfrom the distal end of the connection mechanism;

FIG. 51 is a perspective view of the distal end of the connectionmechanism shown in FIG. 50, in a position ready for connection with theend effector shown in FIG. 50;

FIG. 52 is an enlarged exploded view of the distal end of the connectionmechanism shown in FIG. 51;

FIG. 53 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 50, during a firststep of attaching the end effector to the connection mechanism;

FIG. 54 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 50, during asubsequent attachment step;

FIG. 55 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 50, during anotherattachment step;

FIG. 56 is a top view of the end effector and the distal end of theconnection mechanism shown in FIG. 55, with the tubular body of the endeffector shown in phantom;

FIG. 57 is a cross-sectional view taken along line 57-57 shown in FIG.55;

FIG. 58 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 50, upon completeattachment of the end effector to the distal end of the connectionmechanism;

FIG. 59 is a top view of the end effector and the distal end of theconnection mechanism shown in FIG. 58, with the tubular body of the endeffector shown in phantom;

FIG. 60 is a cross-sectional view taken along line 57-57 shown in FIG.58;

FIG. 61 is a perspective view of an end effector and a distal end of aconnection mechanism according to still yet another embodiment of thepresent disclosure, the end effector being received on the distal end ofthe connection mechanism;

FIG. 62 is a perspective view of the end effector and the distal end ofthe connection mechanism of FIG. 61, the end effector being separatedfrom the distal end of the connection mechanism;

FIG. 63 is a perspective view of the distal end of the connectionmechanism shown in FIG. 50, with the outer tube removed;

FIG. 64 is an enlarged exploded view of the distal end of the connectionmechanism shown in FIG. 63;

FIG. 65 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 61, during a firststep of attaching the end effector to the connection mechanism;

FIG. 66 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 61, during asubsequent attachment step;

FIG. 67 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 61, during anotherattachment step;

FIG. 68 is a cross-sectional view taken along line 68-68 shown in FIG.67;

FIG. 69 is a cross-sectional side view of the end effector and thedistal end of the connection mechanism shown in FIG. 61, upon completeattachment of the end effector to the distal end of the connectionmechanism;

FIG. 70 is a cross-sectional view taken along line 70-70 shown in FIG.69;

FIG. 71 is a perspective view of a holder according to an embodiment ofthe present disclosure, in a first or insertion position;

FIG. 72 is a perspective view of the holder shown in FIG. 71, in asecond or operative position;

FIG. 73 is a perspective view of the holder shown in FIG. 71, operablyengaged with an end effector;

FIG. 74 is a perspective view of the holder shown in FIG. 71, operablyengaged with the end effector shown in FIG. 73;

FIG. 75 is an exploded view of the holder show in FIG. 71;

FIG. 76 is a side view of the holder and end effector of FIG. 73, priorto attachment with a distal end of a connection mechanism;

FIG. 77 is a side view of the holder, the end effector, and the distalend of the connection mechanism shown in FIG. 76, upon attachment of theend effector to the distal end of the connection mechanism; and

FIG. 78 is a side view of the holder, the end effector, and the distalend of the connection mechanism shown in FIG. 76, upon release of theend effector from the holder.

DETAILED DESCRIPTION

Embodiments of the presently disclosed system for performing endoscopicprocedures will now be described in detail with reference to thedrawings in which like reference numerals designate identical orcorresponding elements in each of the several views. As is common in theart, the term “proximal” refers to that part or component closer to theuser or operator, i.e., surgeon or physician, while the term “distal”refers to that part or component further away from the user.

With reference initially to FIG. 1, an endoscopic instrument accordingto an embodiment of the present disclosure is shown generally asendoscopic instrument 100. Instrument 100 includes an actuation assembly102 and an end effector 200. As will be discussed in further detailbelow, instrument 100 is configured such that end effector 200 may beattached, operated, and separated from actuation assembly 102 during alaparoscopic procedure, and more particularly, while end effector 200 isdisposed within a body cavity. Although shown and described for use witha grasping end effector, it is envisioned that actuation assembly 102may be used with other types of end effectors, including those forstapling, vessel sealing and cutting. As will be discussed in furtherdetail below, actuation assembly 102 may be modified for use with any ofthe presently disclosed end effectors. It is further envisioned that endeffector 200 may be modified for use with other actuation assemblies.

With reference now to FIGS. 1-5, actuation assembly 102 includes ahandle assembly 104 and a shaft assembly 106 extending from handleassembly 104. With particular reference to FIG. 5, handle assembly 104includes a base member 110, a trigger mechanism 120, a slider mechanism130, a drive mechanism 140, and a latch mechanism 150.

With reference still to FIGS. 1-5, base member 110 includes a handleportion 112 and a distal extension 114 and defines a cutout 111therebetween. Cutout 111 is configured to operably receive an actuationlink 126 of trigger mechanism 120. Defined within cutout 111 is a firstopening 111 a configured to receive a pivot pin 124 a of triggermechanism 120 for pivotally securing trigger 122 of trigger mechanism120 to handle assembly 104, a second opening 111 b configured to receivea first portion of a pivot member 128 of trigger link 126 of triggermechanism 120, a third opening 111 c configured to receive a pivotmember 158 of latch mechanism 150, and a notch 111 d configured toselectively receive a first lock member 154 of latch mechanism 150.

With particular reference to FIG. 5, base member 110 further includes acover plate 113 for covering cutout 111. Cover plate 113 defines aplurality of opening corresponding to openings in cutout 111. Inparticular, cover plate 113 includes a first opening 113 a configured toreceive pivot pin 124 a of trigger mechanism 120 and a second opening113 a configured to receive a second portion of pivot member 128 oftrigger link 126. A recess 109 is formed about cutout 111 and isconfigured to accommodate cover plate 113. As shown, a plurality ofopenings 109′ are defined within recess 109 and correspond in number andlocation to a plurality of openings 113′ formed in cover plate 113.Openings 109′ formed in recess 109 and openings 113′ formed in coverplate 113 are each configured to receive a screw (not shown) forsecuring cover plate 113 to base member 110. Although described as beingsecured to base member 110 using a plurality of screws, cover plate 113may be secured to base member 110 using any suitable technique, i.e.,adhesive, welding, snap-fit.

With particular reference still to FIG. 5, handle portion 112 of basemember 110 is configured for operable engagement by a user. Handleportion 112 may be ergonomically formed and may include knurling, grips,non-slip coating or other features (not shown) to facilitate engagementby a user. Distal extension 114 of base member 110 includes a first rail116 and a second rail 118. First rail 116 extends longitudinally along aproximal portion of distal extension 114 and is configured to support aslider extension 136 of slider mechanism 130 in a sliding manner. Secondrail 118 extends longitudinally along a central portion of distalextension 114 and is configured to be slidably received within a groove142 b of a drive box 142 of drive mechanism 140. Distal extension 114defines a channel 115 extending longitudinally along a distal portionthereof. Channel 115 is configured to slidably receive slider 132 ofslider mechanism 130. Channel 115 is further configured to receive aspring 115 a. Spring 115 a is configured to bias slide mechanism 130distally.

Still referring to FIGS. 1-5, trigger mechanism 120 includes a trigger122 and a trigger link 126. As shown, trigger 122 includes asubstantially oval-shaped member defining an opening 123 configured toaccommodate the fingers of a user. A flange 124 extends from trigger 122and is configured to be received within cutout 113 formed between handleportion 112 and distal extension 114 of handle assembly 104. Flange 124is pivotally secured within cutout 113 by pivot pin 124 a supportedwithin first openings 111 a, 113 a in respective cutout 111 and coverplate 113. Flange 124 defines a first notch 123 a and a second notch 123b. First notch 123 a is configured to selectively receive a first lockmember 154 of latch mechanism 150. Second notch 123 b is configured tooperably receive a first end 126 a of trigger link 126. Trigger link 126defines a substantially triangular cross-section having first end 126 aand a second end 126 b. Although shown having substantially ball-shapedends 126 a, 126 b, it is envisioned that first and second ends 126 a,126 b may have any suitable shape. A pivot member 128 extends laterallyfrom trigger link 126. As discussed above, pivot member 128 includes thefirst portion configured to be pivotally received within second opening111 b formed in cutout 111 of base member 110 and the second portionconfigured to be pivotally received within second opening 113 b formedin cover plate 113.

With reference still to FIGS. 1-5, slider mechanism 130 includes slider132 and slider extension 136. Slider extension 136 is configured to besecured to a proximal end of slider 132 to define a recess 133 (FIG. 2).Recess 133 is configured to accommodate drive mechanism 140 when slider132 and slider extension 136 are secured to distal extension 114 ofhandle assembly 104. Although shown as separate members, it isenvisioned that slider 132 and extension 136 may be integrally formed. Afirst rail 134 a extends longitudinally along a distal portion of slider132. First rail 134 a is configured to be received within channel 115defined by extension 114 of handle assembly 104. Although shown withfirst rail 124 a being formed on slider 132 and channel 115 beingdefined by distal extension 114, it is envisioned that distal extension114 may instead include a first rail and slider 132 may define achannel. A second rail 134 b extends longitudinally along a proximalportion of slider 132. Second rail 134 b is configured to be receivedwithin a groove 142 a formed in drive box 142 of drive mechanism 140.Receipt of second rail 134 within channel 115 permits longitudinalmovement of slider extension 136. Slider 132 defines a notch 135 toaccommodate a rotation knob 161 of connection mechanism 160. Slider 132further defines a bore 137 extending longitudinally through a distalportion of slider 132 configured to operably receive connectionmechanism 160.

Still referring to FIGS. 1-5, slider extension 136 defines a channel 139a extending along a bottom surface 136 a thereof configured to receivefirst rail 116 formed on distal extension 114 of handle assembly 104.Receipt of first rail 116 within channel 139 a permits longitudinalmovement of slider extension 136 relative to distal extension 114.Accordingly, when slider extension 136 is affixed to slider 132 andfirst rail 134 a of slider 132 is received within channel 115 of distalextension 114 and first rail 116 of distal extension 114 is receivedwithin channel 139 a of slider 132, slider mechanism 130 islongitudinally positionable relative to distal extension 114. Asdiscussed above, channel 115 is configured to receive spring 115 a.Spring 115 a is configured to bias slider mechanism 130 distally. Sliderextension 136 further defines a bore 139 configured to securely retain aproximal end of center rod 168 of connection mechanism 160.

With reference now to FIGS. 5, 11, and 13, drive mechanism 140 includesa drive box 142 and a button member 146. Drive box 142 defines a pair ofgrooves 142 a, 142 b formed on top and bottom surfaces, respectively,thereof extending the length drive box 142. As noted above, groove 142 bis configured to receive second rail 118 formed on distal extension 114of base portion 110 and groove 142 a is configured to receive first rail134 a formed on slider 132 of slider mechanism 130. Drive box 142further includes a longitudinal bore 141 extending longitudinallytherethrough. A first or proximal section 141 a of bore 141 includes afirst diameter configured to slidably receive center rod 168 ofconnection mechanism 160 therethrough. A second or middle section 141 bof bore 141 includes a second diameter configured to slidably receive anannular flange 167 formed on a proximal end of inner tube 166 ofconnection mechanism 160 and a spring 148. A third or distal section 141c of bore 141 includes a third diameter configured to securely receivean annular flange 165 formed on a proximal end of center tube 164 ofconnection mechanism 160. Drive box 142 further defines an opening 143extending laterally therethrough along the length thereof. A firstsection 143 a of opening 143 is configured to accommodate the receipt ofspring 148 within second section 141 b of bore 141. A second section 143b of opening 143 is configured to slidably receive button member 146therethrough. Drive box 142 also includes an opening 145 a in a bottomsurface thereof and a pair of openings 145 b extending laterallytherethrough. Opening 145 a in the bottom surface of drive box 142 isconfigured for operative reception of second end 126 b of trigger link128 of trigger mechanism 120. Each of openings 145 b extends laterallythrough drive box 142 and is configured to receive a pin 145′ forsecuring annular flange 165 of center tube 164 to drive box 142.

With particular reference to FIG. 13, button member 146 of drivemechanism 130 includes a substantially elongate body defining a slot147. Slot 147 is defined by a first section 147 a of button member 146configured to securely engage inner tube 166 of connector mechanism 160and a second section 147 b of button member 147 b configured to permitpassage of annular flange 165 formed on the proximal end of inner tube154 through button member 146. Button member 146 includes an enlargedfirst end 146 a and a second end 146 b configured to be received throughdistal section 143 b of opening 143 in drive box 142. A cap member 149is configured to be secured to second end 146 b of button member 146once distal section 146 b has been received through distal section 143 bof opening 143 to secure button member 146 to drive box 142. Each ofenlarged first end 146 a and cap member 149 are configured forengagement by a user to permit lateral movement of button member 146relative to drive box 142.

Turing briefly to FIGS. 11 and 14, when drive mechanism 140 is in afirst or unlocked condition, inner tube 166 is received through secondsection 147 b of slot 147 formed in button member 146. In this manner,inner tube 166 is permitted to move longitudinally relative to buttonmember 146 and drive box 142. Spring 148 engages flange 167 of innertube 166 thereby biasing inner tube 166 distally. As shown, the biasprovided by spring 148 against flange 167 of inner tube 166 positionsfingers 166 a of inner tube 166 distally of the distal end of centertube 164. With reference now to FIG. 25, in a second or lockedcondition, after flange 167 (FIG. 23) of inner tube 166 has overcome thebias of spring 148 (FIG. 23) to cause flange 167 to be disposed proximalof button member 146, button member 146 is moved laterally, as indicatedby arrow “E”, to position button member 146 such that inner tube 166 isreceived within first section 147 a of slot 147 formed in button member146, thereby securing inner tube 166 relative to button member 146 anddrive box 142. Returning button member 146 to its original position(FIG. 14) unlocks drive mechanism 140, thereby allowing longitudinalmovement of inner tube 166 relative to drive box 142.

With reference back to FIG. 5, latch mechanism 150 includes a latchlever 152, a first lock member 154, a pair of second lock members 156,and a pivot member 158. Latch lever 152 is configured for operableengagement by the user. A distal end of latch lever 152 is secured tofirst lock member 154 in any suitable manner, i.e., adhesive. First lockmember 154 defines a substantially planar member configured to beselectively received within notch 111 c formed in base member 110 andwithin first notch 123 a formed in flange 124 extending from trigger 122of trigger mechanism 120. First lock member 154 is secured to each ofsecond lock members 156 in any suitable manner, i.e., adhesive. Secondlock members 156 each include an opening 157 a and a cutout 157 b.Openings 157 a are each configured to receive an end of pivot member158. Cutout 157 b is configured to be selectively received about bottomsurface 136 a of slider extension 136 of slider mechanisms 130. Secondlock members 156 each include a proximal facing surface 156 a configuredto selectively engage slider extension 136. Latch mechanism 150 furtherincludes a pair of springs 159 configured to bias second lock members156 upward. Although shown as separate members, it is envisioned thatlatch lever 152, first lock member 154 and second lock members may beintegrally formed.

Latch mechanism 150 is moveable about pivot member 158 between multiplelocking positions. In a first locking position, as shown in FIG. 2,second lock members 156 are biased upward by springs 159 such thatbottom surface 136 a of slider extensions 136 of slider mechanism 130 isreceived within cutouts 157 b. As discussed above, receipt of bottomsurface 136 a of slider extension 136 within cutouts 157 b preventsretraction of slider mechanism 130. In a second locking position, asshown in FIGS. 17 and 18, latch lever 152 is pushed downward, asindicated by arrow “B”, against the bias of springs 159 to move secondlock members 156 from about bottom surface 136 a of slider extension136. Latch mechanism 150 is maintained in the second position throughengagement of second lock members 156 with bottom surface 136 a ofslider extension 136. In the second locking position, first lock member154 is received within first notch 123 a formed in flange 124 extendingfrom trigger 122 of trigger mechanism 120. Receipt of first lock member154 in first notch 123 a prevents movement of trigger 122. In a thirdlocking position, as shown in FIGS. 21 and 22, complete retraction ofslider mechanism 130 allows springs 159 to bias second lock members 156upward, as indicated by arrow “C”. As such, proximal facing surfaces 156a of second lock members 156 engage a distal surface 136 b of sliderextension 136 to maintain slider mechanism 130 in the completelyretracted position. The upward movement of second lock members 156 alsowithdraws first lock member 154 from within first notch 123 a formed inflange 124 extending from trigger 122, thereby releasing trigger 122.

With reference now to FIGS. 5, 6 and 8, shaft assembly 106 includes aconnection mechanism 160 having a first or outer tube 162, a second orcenter tube 164, a third or inner tube 166, and a center rod 168. Outertube 162 is configured to fixedly support rotation knob 161 on aproximal end and includes collet 163 formed on a distal end. Rotationknob 161 operates to secure outer tube 162 to slider 132 of slidermechanism 130 and allows a user to cause the rotation of outer tube 162along a longitudinal axis “x” (FIG. 1). As will become apparent below,because end effector 200 is rotationally secured to outer tube 162 ofconnection mechanism 160, rotation of outer tube 162 about longitudinalaxis “x” causes rotation of end effector 200 about longitudinal axis“x”. Collet 163 includes a pair of arms 163 a. As shown, each arm 163 aincludes a rounded protrusion 163 b. Arms 163 a are configured to flexoutwardly upon receipt of center tube 164 therethrough. Although shownincluding a pair of arms 163 a, it is envisioned that collet 163 mayinclude more than two arms 163 a.

Center tube 164 is configured to be received within outer tube 162 andincludes flange 165 on a distal end thereof. As discussed above, flange165 operates to secure center tube 164 to drive box 142 of drivemechanism 140. Inner tube 166 is configured to be received within centertube 164. Inner tube 166 includes a plurality of fingers 166 a on adistal end thereof configured to permit the expansion of the distal endof inner tube 166 to facilitate attachment of inner tube 166 with a linkmember 232 of jaw assembly 230 of end effector 200. Inner surfaces offingers 166 a include ridges 162 b (FIG. 12) configured to engagecorresponding ridges 234 (FIG. 9) formed on link member 232 of endeffector 200. As discussed above, the proximal end of inner tube 166includes flange 167 configured for selective engagement with buttonmember 146 of drive mechanism 140. As seen in FIGS. 11 and 12, innertube 166 has a length such that when flange 167 is biased to adistal-most position by spring 148, fingers 166 a formed on the distalend of inner tube 166 are disposed distally of the distal end of centertube 164. In this manner, and as will be discussed in further detailbelow, fingers 166 a of inner tube 166 engage proximal end 232 a of linkmember 232 prior to engagement of link member 232 by center tube 164.Center rod 168 includes a proximal end configure to be secured withinbore 139 of slider extension 136 of slider mechanism 130 and a pointeddistal end 168 b.

As noted above, since outer tube 162 of connection mechanism 160 issecured to slider 132 of slider mechanism 130 and center rod 168 ofconnection mechanism 160 is secured to slider extension 136 of slidermechanism 130, and each of slider 132 and slider extensions 136 arelongitudinally fixed relative to each other, each of outer tube 162 andcenter rod 168 are also longitudinally fixed relative to each other.Accordingly, pointed distal end 168 b of center rod 168 is alwaysdisposed distally of collet 163. As also noted above, center tube 164 islongitudinally fixed relative to drive box 142 and inner tube 166 isselectively longitudinally fixed relative to drive box 142 throughoperation of button member 146.

With reference now to FIGS. 6, 7 and 9, end effector 200 includes aconnection assembly 210 and a jaw assembly 230. Connection assembly 210includes a tubular body 212 having a pair of distal supports 214extending distally therefrom for operable engagement with jaw assembly230. Each arm 214 includes a slot 213 and an opening 215. Slot 213 isconfigured to receive a connecting pin 216 and opening 215 is configuredto receive a pivot pin 218. Tubular body 212 defines a pair of cutouts219 extending therethrough configured to receive protrusions 163 b (FIG.8) of arms 163 a of collet 163 formed on the distal end of outer tube162 when arms 163 a are in an outwardly flexed condition. Cutouts 219correspond in number and location to arms 163 a of collet 163. Asdiscussed above, it is envisioned that collet 163 may have more than twoarms 163 a, therefore tubular body 212 may include more than two cutouts219.

With reference still to FIGS. 6, 7 and 9, jaw assembly 230 includes alink member 232, a first jaw member 240, and a second jaw member 250.Link member 232 includes a proximal end 232 a having a plurality ofridges 234 and a substantially planar distal end 232 b defining anopening 233. Each of first and second jaw members 240, 250 include aproximal end 240 a, 250 a having a diagonal slot 241, 251, respectively,and an opening 243, 253, respectively. A cutout 245, 255 on proximal end240 a, 250 a, respectively, of each of respective first and second jawmembers 240, 250 is configured to accommodate distal end 232 b of linkmember 232. A distal end 240 b of first jaw member 240 includes aplurality of teeth 246. A distal end 250 b of second jaw member 250includes a plurality of teeth 256 configured to mesh with teeth 246 offirst jaw member 240 when first and second jaw members 240, 250 are in aclosed position, i.e., engage one another (FIG. 15). First and secondjaw members 240, 250 are pivotally secured to distal supports 214 oftubular member 210 by pivot pin 218 received through openings 243, 253of respective first and second jaw members 240, 250 and through openings215 in distal supports 214. Connecting pin 216 is received throughdiagonal slots 241, 251 of respective first and second jaw members 240,250, through slots 213 formed in distal supports 214, and throughopening 233 formed in link member 232. Turning briefly to FIG. 27, jawassembly 230 is configured such that distal advancement of connectingpin 216 through slots 213 of distal supports 214, as indicated by arrows“D”, causes first and second jaw members 240, 250 of jaw assembly 230 tomove to an open position.

The operation of endoscopic instrument 100 will now be described withreference to FIGS. 1-30. As shown in FIGS. 1-4 and 10-16, actuationassembly 102 is in a first or percutaneous position. In the percutaneousposition, slider 132 and slider extension 136 of slider mechanism 130are supported on extension 114 of base member 110 in an advanced ordistal-most position. While in the percutaneous position, latchmechanism 150 operates to retain slider 132 and slider extension 136 inthe advance position. In particular, second lock members 156 of latchmechanism 150 are biased upward by springs 159 to capture bottom surface136 a of slider extension 136 within cutouts 157 b of second lockmembers 156.

In the percutaneous position, trigger 122 of trigger mechanism 120 anddrive box 142 of drive mechanism 140 are in a retracted position. Asdiscussed above, since outer tube 162 of connection mechanism 160 issecured to slider 132 of slider mechanism 130 and center rod 168 issecured to slider extension 136 and slider extension 136 is fixedrelative to slider 132 outer tube 162 and center rod 168 are fixedrelative to each other. As seen in FIG. 12, the advanced position ofslider mechanism 130 relative to the retracted position of drivemechanism 140 results in the distal ends of center tube 164 and innertube 166, respectively, being disposed proximally of collet 163 of outertube 162. In the percutaneous position, a distal end of connectionmechanism 160 is capable of penetrating through tissue of a patient andinto a body cavity. Penetration through tissue may be accomplishedthrough an incision formed in the tissue or through a port assemblypreviously received through the tissue. Alternatively, pointed distalend 168 b of center rod 168 may be sufficiently sharp to facilitate theunaided piercing of the tissue.

With particular reference now to FIGS. 15 and 16, once the distal end ofconnection mechanism 160 has been received within a body cavity,connection mechanism 160 may be secured to end effector 200. Morespecifically, the distal end connection mechanism 160 is received withintubular body 212 of connector assembly 210 such that pointed distal end168 b of center rod 168 engages link member 232 of jaw assembly 230 andcollet 163 is aligned with cutouts 219. The positioning of end effector200 within the body cavity and the manipulation of end effector 200during attachment to connector mechanism 160 may be facilitated by aholder 800 (FIG. 71), as will be discussed in detail below, or othergripping instrument.

Turning now to FIGS. 17-20, actuation assembly 102 is shown in a secondor intermediate position. In the intermediate position, latch member 152is pushed downward against the bias of springs 159, in the directionindicated by arrow “B”, to disengage second lock members 156 from bottomsurface 136 a of slider extension 136 of slider mechanism 130. Bydisengaging slider extension 136, slider 132 and slider extension 136are permitted to be retracted proximally, in the direction indicated byarrow “E”. The downward movement of latch member 152 causes first lockmember 154 to be received within first notch 123 a (FIG. 18) formed inflange 124 extending from trigger 122. In this manner, trigger 122 isprevented from being moved. Latch member 152 is maintained in thedownward position by engagement of second lock members 156 with sliderextension 136.

Still referring to FIGS. 17-20, retraction of slider 132 and sliderextension 136 of slider mechanism 130 relative to drive box 142 of drivemechanism 140 causes retraction of outer tube 162 and center rod 168relative to center tube 164. The retraction of outer tube 162 relativeto center tube 164 results in the movement of the distal end of centertube 164 through collet 163 of outer tube 162. As discussed about,receipt of center tube 164 through collet 163 of outer tube 162 causesarms 163 a of collet 163 to flex outwardly. As arms 163 a are flexedoutwardly, protrusions 163 b formed on arms 163 are received withincutouts 219 of tubular body 212, thereby securing end effector 200 toshaft assembly 106.

Once protrusions 163 b formed on arms 163 a of collet 163 are receivedwithin cutouts 219 of tubular body 212 to secure end effector 200 toshaft assembly 106, continued retraction of outer tube 162 relative tocenter tube 164 causes retraction of end effector 200 relative to centertube 164. Since inner tube 166 is maintained relative to center tube 164by spring 148, retraction of end effector 200 relative to center tube164 causes corresponding retraction of end effector 200 relative toinner tube 166. As noted above, the distal end of inner tube 166 ismaintained distally of a distal end of center tube 164 through the biasof spring 148. As such, as end effector 200 is retracted relative tocenter tube 164, fingers 166 a of inner tube 166 engage proximal end 232a of link member 232 and are flexed outwardly to accommodate receptionof fingers 166 a about proximal end 232 a. Once fingers 166 a of innertube 166 are completely received about proximal end 232 a of link member232, ridges 166 b formed on fingers 166 a engage ridges 134 formed onproximal end 232 a and fingers 166 a returned to a pre-flexed condition.

With reference now to FIGS. 21-25, actuation assembly 102 is shown in anengaged position. Once slider 132 and slider extension 136 have beencompletely retracted, second lock members 156 of latch mechanism 150 areno longer retained in the downward position by slider extension 136. Assuch, springs 159 bias second lock members 156 upward. As discussedabove, second lock members 156 each include a proximal facing surface156 a that engages slider extension 136 when slider mechanism 130 is ina fully retracted position. In this manner, slider mechanism 130 isprevented from advancing, i.e., returning to the pre-retracted position(FIG. 1), while latch lever 152 is in the upward position. Upwardmovement of second lock members 156 causes first lock member 154 to beremoved from within first notch 123 a formed in flange 122 of trigger120, thereby allowing movement of trigger 122.

As discussed above, during movement of slider mechanism 130 to theintermediate position, fingers 166 a of inner tube 166 engage and arereceived about proximal end 232 a of link member 232. Once fingers 166 aof inner tube 166 are complete received about proximal end 232 a,continued retraction of slider mechanism 130 causes continued retractionof end effector 200 relative to center tube 164; however, because innertube 166 is secured to link member 232, retraction of end effector 200relative to center tube 164 overcomes the bias provided by spring 148 tocause the retraction of inner tube 166 relative to center tube 164. Asseen in FIG. 23, the retraction of inner tube 166 relative to centertube 164 causes flange 167 formed on the proximal end of inner tube 166to be moved proximally of button member 146. At the same time, thedistal end of center tube 164 is positioned about fingers 166 a of innertube 166. The positioning of center tube 164 about inner tube 166prevents splaying of fingers 166 a of inner tube 166, thereby ensuringfingers 166 a of inner tube 166 remains attached to proximal end 232 aof link member 232.

With reference now to FIGS. 23-25, once distal ends of center tube 164and inner tube 166 are received about proximal end 232 a of link member232, i.e., upon complete retraction of slider mechanism 130, buttonmember 146 of drive mechanism 140 is moved laterally, as indicated byarrow “E” (FIG. 25), to position button member 146 such that inner tube166 is received within first section 147 a of button member 146 formingslot 147. As discussed above, first section 147 a of button member 146forming slot 147 is configured to engage inner tube 166 such that innertube 166 is fixed relative to drive box 142. In this manner, advancementand/or retraction of drive box 142 causes corresponding advancementand/or retraction of both center tube 164 and inner tube 166.

Turning now to FIGS. 26-30, once inner tube 166 is secured relative todrive box 142 of drive mechanism 140 endoscopic instrument 100 is readyfor use. Movement of trigger 122 of trigger mechanism 120 away fromhandle portion 112 of base member 110, as indicated by arrow “F”, causesopening of jaw assembly 230. In particular, movement of trigger 122 awayfrom handle portion 112 causes trigger link 126 to pivot about pivotmember 128 (FIG. 5) thereby causing distal advancement of drive box 142of drive mechanism 140, as indicated by arrow “G” (FIG. 29). Asdiscussed above, center and inner tubes 164, 166 are fixed relative todrive box 142, thus, distal advancement of drive box 142 results indistal advancement of center and inner tubes 164, 166.

With particular reference to FIGS. 27 and 30, distal advancement ofcenter and inner tubes 164, 166 causes distal advancement of link member232 of jaw assembly 230 relative to tubular member 212. Distaladvancement of link member 232 causes advancement of connecting pin 216,as indicated by arrow “D”. As discussed above, connecting pin 216 isreceived with diagonal slots 241, 251 of respective first and second jawmembers 240, 250. As such movement of connecting pin 216 in the distaldirection causes first and second jaw members to pivot away from eachother. In this manner, movement of trigger 122 away from handle portion114 of base member 110 causes opening of jaw assembly 230. Conversely,the return of trigger 122 towards handle portion 114 causes first andsecond jaw members 240, 250 to move towards each other, thereby closingjaw assembly 230. Trigger 122 may be moved towards and away from handleportion 114 as needed to cause the opening and closing of jaw assembly230.

Once end effector 200 is secured to connection mechanism 160 ofactuation assembly 102, endoscopic instrument 100 may be used as atraditional grasper. As noted above, movement of trigger away from andtowards handle portion 114 of base member 110 causes opening andclosing, respectively, of jaw assembly 230. Jaw assembly 230 may also berotated about longitudinal axis “x” using rotation knob 161 which issecured to the distal end of outer tube 162.

At any point during a procedure, end effector 200 may be disengaged fromconnection mechanism 160 of actuation assembly 102 in the reverse mannerof attachment. Specifically, trigger 122 is moved towards handle portion112 to retract drive box 142 to its proximal-most position. Buttonmember 146 is then moved laterally to align second section 147 b of slot147 with inner tube 164 to permit longitudinal movement of inner tuberelative to drive box 142. Latch lever 152 is then pushed downed todisengage second lock members 156 from slider extension 136 to permitdistal advancement of slider mechanism 130. Distal advancement of slidermechanism 130 cause retraction center and inner tubes 164, 166 relativeto link member 232 of end effector 200. Initial distal advancement ofslider mechanism 130 causes inner tube 166 to disengage from proximalend 232 a of link member 232. Continued distal advancement of slidermechanism 130 causes distal ends of center and inner tubes 164, 166 tobe retracted distally relative to collet 163 formed on outer tube 162.Retraction of center tube 164 from within collet 163 permits arms 163 aof collet 163 to return to non-flexed position, thereby disengagingrounded protrusions 163 b of arms 163 a from within cutouts 219. In thismanner, end effector 200 is no longer secured to connection mechanism160 of actuation assembly 102 and may be removed from connection withouter tube 162.

As noted above, actuation assembly 102 may be used with alternative endeffectors. Once the endoscopic procedure is completed, connectionmechanism 160 of actuation assembly 102 may be removed from with in thebody cavity and the incision may be closed. End effector 200 may also beremoved from within the body cavity through the same incision or portthrough which end effector 200 was inserted into the body cavity.

As discussed above, connection mechanism 160 of actuation assembly 102includes a first diameter configured to be received through a firstopening in tissue, i.e., through an incision or access device, having afirst diameter. One or more end effectors 200 having a second largerdiameter are configured to be received through a second opening intissue, i.e., through an incision or access device, having a secondlarger diameter. In one embodiment, shaft assembly 106 of endoscopicinstrument 100 is configured to be received through an opening measuring3 mm in diameter, while end effector 200 is configured to be receivedthrough an opening measuring 5 mm in diameter. More then one endeffector may be introduced through the second opening, thereby limitingthe number of openings necessary to complete an endoscopic procedure.The ability to interchange end effectors within the body cavity means asurgeon does not have to retract shaft assembly 106 from within the bodycavity to change end effectors. In this manner, the number ofopportunities for introducing contaminates within the surgical site isalso limited.

With reference now to FIGS. 31-38, an end effector according to anotherembodiment of the present disclosure is shown generally as end effector300. End effector 300 is substantially similar in structure and functionto end effector 200. Although end effector 300 will be described asrelates to selective attachment to a connection mechanism 360, it isenvisioned that connection mechanism 160 of actuation assembly 102described hereinabove may be modified for use with end effector 300. Itis also envisioned that end effector 300 may be modified for use withalternative connection mechanism.

With continued reference to FIGS. 31-38, end effector 300 includes aconnection assembly 310 and a jaw assembly 330. Connection assembly 310includes a tubular body 312 having a pair of distal supports 314extending distally therefrom for operable engagement with jaw assembly330. Each distal support 314 includes a slot 313 and an opening 315.Slot 313 is configured to receive a connecting pin 316 and opening 315is configured to receive a pivot pin 318. Tubular body 312 defines apair of cutouts 319 extending therethrough configured to receiveprotrusions 363 b of arms 363 a of a collet 363 formed on a distal endof an outer tube 362 of collection mechanism 360 when arms 363 a are inan expanded condition. Cutouts 319 correspond in number and location toarms 363 a of collet 363 on outer tube 362.

With reference still to FIGS. 31-38, jaw assembly 330 includes a linkmember 332, a first jaw member 340, and a second jaw member 350. Linkmember 332 includes a proximal end 332 a having a plurality of ridges334 and a substantially planar distal end 332 b defining an opening 333.Each of first and second jaw members 340, 350 include a proximal end 340a, 350 a, respectively, having a diagonal slot 341, 351, respectively,and an opening 343, 353, respectively. A cutout 345, 355 on proximal end340 a, 350 a, respectively, of each of first and second jaw members 340,350, respectively, is configured to accommodate distal end 332 b of linkmember 332. A distal end 340 b of first jaw member 340 includes aplurality of teeth 346. A distal end 350 b of second jaw member 350includes a plurality of teeth 356 configured to mesh with teeth 346 offirst jaw member 340 when first and second jaw members 340, 350 are in aclosed position (FIG. 31), i.e., engage one another.

Still referring to FIGS. 31-38, first and second jaw members 340, 350are pivotally secured to distal supports 314 of tubular member 310 bypivot pin 318 received through openings 343, 353 of respective first andsecond jaw members 340, 350 and through openings 315 in distal supports314. Connecting pin 316 is received through diagonal slots 341, 351 ofrespective first and second jaw members 340, 350, through slots 313formed in distal supports 314, and through opening 333 formed in linkmember 332. Jaw assembly 330 is configured such that distal advancementof connecting pin 316 through slots 313 of distal supports 314 causesopening of jaw assembly 330.

With particular reference now to FIGS. 33 and 34, end effector 300 isconfigured for attachment to an actuation assembly (not shown) includingconnection mechanism 360. Connection mechanism 360 includes outer tube362, a center tube 364 and an inner tube 366. Outer tube 362 includescollet 363 having a pair of arms 363 a. As noted above, each of arms 363a includes a protrusion 363 b configured to be received within cutouts319 defined by tubular member 312. Arms 363 a are configured to flexoutwardly upon receipt of center tube 364 therethrough. Inner tube 366includes a distal end having a plurality of fingers 366 a extendingdistally. An inner surface of fingers 366 a includes ridges 366 bconfigured to engage ridges 334 formed on proximal end 332 a of linkmember 332.

The attachment of end effector 300 to connection mechanism 360 will nowbe described with reference to FIGS. 35-38. Referring initially to FIG.35, distal end of outer tube 362 is received within tubular member 312of connection assembly 310 such that protrusions 363 b formed on colletarms 363 a are aligned with cutouts 319 defined by tubular member 312.Turning to FIG. 36, center tube 364 is then advanced distally such thata distal end of center tube 364 causes arms 363 a of collet 363 to flexoutwardly such that protrusions 363 b extend within cutouts 319, therebysecuring outer tube 362 to tubular member 312. With reference now toFIG. 37, inner tube 366 is next advanced distally to engage fingers 366a of inner tube 366 with proximal end 332 a of link member 332 such thatridges 366 b formed on the inner surface of fingers 366 a engage ridges334 formed on proximal end 332 a of link member 332. Turning to FIG. 38,center tube 364 is next further advanced distally to cover fingers 366 aof inner tube 366 to prevent fingers 366 a from splaying, therebysecuring the connection between inner tube 366 and link member 332.

Once secured to connection mechanism 360, end effector 300 operates in amanner similar to end effector 200. End effector 300 is removed fromconnection mechanism 360 in the reverse manner of attachment.

With reference now to FIGS. 39-48, an end effector according to stillanother embodiment of the present disclosure is shown generally as endeffector 400. End effector 400 is configured for operable engagementwith an actuation mechanism (not shown) including a connection mechanism460. As discussed above, actuation assembly 102 (FIG. 1) may be modifiedfor use with end effector 400. End effector 400 includes a connectionassembly 410 and a jaw assembly 430.

Connection assembly 410 includes a tubular body 412 having a pair ofdistal supports 314 extending distally therefrom for operable engagementwith jaw assembly 330. Each distal support 414 includes a slot 413 andan opening 415. Slot 413 is configured to receive a connecting pin 416and opening 415 is configured to receive a pivot pin 418. Tubular body412 defines a plurality of cutouts 419 formed on an inner surfacethereof. Cutouts 419 correspond in number and location to arms 463 a ofa collet 463 of an outer tube 462 of connection mechanism 460. As shown,tubular member 410 includes three cutouts 419 corresponding to arms 463a of collet 463. It is envisioned that collet 463 may have only a pairof arms or may instead include more than three arms, therefore tubularbody 412 may include more or less than three cutouts 419. Tubular member410 may also include one or more tabs 414 on an inner surface thereforeto assist in alignment of collet arms 463 with cutouts 419.

With reference to FIGS. 31, 32 and 35-38, jaw assembly 430 includes alink member 432, a first jaw member 440, and a second jaw member 450.Link member 432 includes a proximal end 432 a having a collet 434 formedby a plurality of arms 434 a. Each arm 434 a includes a protrusion 434b. As shown, collet 434 includes three arms 434 a, however, it isenvisioned that collet 434 may have more or less then three arms. Linkmember 432 includes a substantially planar distal end 432 b defining anopening 433. Each of first and second jaw members 440, 450 include aproximal end 440 a, 450 a having a diagonal slot 441, 451, respectively,and an opening 443, 453, respectively. A cutout 445, 455 on proximal end440 a, 450 a, respectively, of each of first and second jaw members 440,450, respectively, is configured to accommodate distal end 432 b of linkmember 432. A distal end 440 b of first jaw member 440 includes aplurality of teeth 446. A distal end 450 b of second jaw member 450includes a plurality of teeth 456 configured to engage teeth 446 offirst jaw member 440 when first and second jaw members 440, 450 engageone another.

With continued reference to FIGS. 31, 32 and 35-38, first and second jawmembers 440, 450 are pivotally secured to distal supports 414 of tubularmember 410 by pivot pin 418 received through openings 443, 453 ofrespective first and second jaw members 440, 450 and through openings415 in arms 414. Connecting pin 416 is received through diagonal slots441, 451 of respective first and second jaw members 440, 450, throughslots 413 formed in distal supports 414, and through opening 433 formedin link member 432. Jaw assembly 430 is configured such that distaladvancement of connecting pin 416 through slots 413 of distal supports414 causes opening of jaw assembly 430.

With particular reference to FIGS. 41-44, end effector 400 is configuredfor attachment to an actuation assembly (not shown) having a connectionmechanism 460. Connection mechanism 460 includes outer tube 462, aninner tube 464 and a center rod 466. As noted above, outer tube 462includes collet 463 having a plurality of arms 463 a. Each of arms 463 aincludes a protrusion 463 b configured to be received within cutouts 419defined by tubular member 412. Arms 463 a are configured to flexoutwardly upon receipt of inner tube 464 therethrough. Inner tube 464defines a plurality of cutouts 465 configured to receive protrusions 434b of arms 434 a of collet 434 formed on proximal end 432 a of linkmember 432. Cutouts 465 correspond in number and location to arms 434 a.Center rod 466 includes a tapered distal end 466 b configured forfacilitating reception of center rod 466 within proximal end 432 a oflink member 432 to cause the flexing of arms 463 a of collet 463. Inaddition, with particular reference to FIG. 41, prior to attachment ofend effector 400 to connection mechanism 460, tapered distal end 466 bof center rod 466 may be used to facilitate insertion of connectionmechanism 460 through tissue into a body cavity. Center rod 466 includesa lip 468 spaced proximally from tapered distal end 466 b and extendingcircumferentially thereabout. Lip 468 is configured to preventover-insertion of center rod 466 within collet 434 of link member 432.

The attachment of end effector 400 to connection mechanism 460 will nowbe described with reference to FIGS. 46-48. Referring initially to FIG.46, distal end of outer tube 462 is received with tubular member 412 ofconnection assembly 410 such that protrusions 463 b formed on colletarms 463 a are aligned with cutouts 419 defined by tubular member 412.As noted above, tubular member 412 may include one or more tabs 414 onan inner surface therefore to assist in alignment of collet arms 463with cutouts 419. Turning to FIG. 47, inner tube 464 is then advanceddistally such the distal end thereof is received over proximal end 432 aof link member 432. The distal advancement of inner tube 364 throughcollet 463 causes arms 463 a of collet 463 to flex outwardly such thatprotrusions 463 b extend with cutouts 419, thereby securing outer tube462 to tubular member 412. With reference now to FIG. 48, center rod 466is then advanced distally until lip 468 on center rod 466 engages collet463. Advancement of tapered distal end 166 b of center rod 466 withincollet 434 of link member 432 causes arms 434 a of collet 434 to flexoutwardly such that protrusions 434 b extend within cutouts 419 formedin tubular member 410, thereby securing inner tube 464 to proximal end432 a of link member 432.

Once secured to connection mechanism 460, end effector 400 operates inthe same manner as end effector 200. End effector 400 is removed fromconnection mechanism in the reverse manner of attachment.

With reference now to FIGS. 49-60, an end effector according to yetanother embodiment of the present disclosure is shown generally as endeffector 500. End effector 500 is configured for operable engagementwith an actuation mechanism (not shown) including a connection mechanism560. As discussed above, actuation assembly 102 (FIG. 1) may be modifiedfor use with end effector 500. End effector 500 includes a connectionassembly 510 and a jaw assembly 530.

With reference to FIGS. 49, 50 and 53-55, connection assembly 510includes a tubular body 512 having a pair of distal supports 514extending distally therefrom for operable engagement with jaw assembly530. Each distal support 514 includes a slot 513 and an opening 515.Slot 513 is configured to receive a connecting pin 516 and opening 515is configured to receive a pivot pin 518. Tubular member 512 defines apair of cutouts 519 extending therethrough. Cutouts 519 correspond innumber and location to arms 563 a of a collet 563 of an outer tube 562of connection mechanism 560. As shown, tubular member 510 includes twocutouts 519 corresponding to arms 563 a of collet 563. It is envisionedthat collet 563 may have more than two arms 563 a, therefore tubularbody 512 may include more than two cutouts 519.

With reference still to FIGS. 49, 50 and 53-55, jaw assembly 530includes a link member 532, a first jaw member 540, and a second jawmember 550. Link member 532 includes a proximal end 532 a defining acavity 533. A groove 533 a is formed on an inner surface of proximal end532 a of link member 532. Link member 532 includes a substantiallyplanar distal end 532 b defining an opening 533. Each of first andsecond jaw members 540, 550 include a proximal end 540 a, 550 a having adiagonal slot 541, 551, respectively, and an opening 543, 553,respectively. A cutout 545, 555 on proximal end 540 a, 550 a,respectively, of each of first and second jaw members 540, 550,respectively, is configured to accommodate distal end 532 b of linkmember 532. A distal end 540 b of first jaw member 540 includes aplurality of teeth 546. A distal end 550 b of second jaw member 550includes a plurality of teeth 556 configured to engage teeth 546 offirst jaw member 540 when first and second jaw members 540, 550 engageone another.

With continued reference to 49, 50 and 53-55, first and second jawmembers 540, 550 are pivotally secured to arms 514 of tubular member 510by pivot pin 518 received through openings 543, 553 of respective firstand second jaw members 540, 550 and through openings 515 in distalsupports 514. Connecting pin 516 is received through diagonal slots 541,551 of respective first and second jaw members 540, 550, through slots513 formed in distal supports 514, and through opening 533 formed inlink member 532. Jaw assembly 530 is configured such that distaladvancement of connecting pin 516 through slots 513 of distal supports514 causes opening of jaw assembly 530.

With reference now to FIGS. 51, 52, 56 and 57, end effector 500 isconfigured for attachment to an actuation assembly (not shown) having aconnection mechanism 560. Briefly, connection mechanism 560 includesouter tube 562, an inner tube 564, a center rod 566, an actuating bar568 and a ring 570. As noted above, outer tube 562 includes collet 563having a pair of arms 563 a. Each arm 563 a includes a protrusion 563 bconfigured to be received within cutouts 519 defined by tubular member512. Arms 563 a are configured to flex outwardly upon receipt of innertube 564 therethrough. Center rod 566 defines a longitudinal channel 567configured to receive actuating bar 568 in a sliding manner. Channel 567includes a proximal section 567 a configured to accommodate an elongatedproximal portion 568 a of actuating bar 568 and a distal section 567 bconfigured to accommodate a widened distal portion 568 b of actuatingbar 568. Center rod 566 further defines an annular groove 569 spacedfrom a distal end of center rod 568 and configured to receive ring 570.As noted above, actuating bar 568 includes elongated proximal portion568 a and widened distal portion 568 b. A transition 568 c betweenproximal portion 568 a and distal portion 568 b is tapered. Ring 570defines a slit 571 sized to receive elongated proximal portion 568 a ofactuating bar 568. With particular reference to FIGS. 56 and 59, whenring 570 is received within annular groove 569 and actuating bar 568 isreceived within channel 567 of center rod 566 such that elongateproximal portion 568 a is received with slit 571 in ring 570, proximalretraction of actuating bar 568 causes transition 568 c between elongateproximal portion 568 a and widened distal portion 568 b to be receivedwith slit 571. Continued proximal retraction of actuating bar 568results in expansion of ring 570.

The attachment of end effector 500 to connection mechanism 560 will nowbe described with reference to FIGS. 53-60. Referring initially to FIG.53, distal end of outer tube 562 is received with tubular member 512 ofconnection assembly 510 of end effector 500 such that protrusions 563 bformed on collet arms 563 a are aligned with cutouts 519 defined bytubular member 512. Turning to FIG. 54, inner tube 564 is then advanceddistally such the distal end thereof is received through collet 563 ofouter tube 562 causing collet arms 563 a to flex outwardly such thatprotrusions 563 b extend within cutouts 519. In this manner, outer tube562 is secured to tubular member 512. With reference now to FIGS. 55-57,center rod 566 is then advanced distally to be received with cavity 533formed in proximal end 532 a of link member 532. Cavity 533 isconfigured such that upon complete reception of the distal end of centerrod 566 within cavity 533, ring 570 mounted on center rod 566 is alignedwith groove 533 a formed on the inner surface of proximal end 532 a oflink member 532. Turning to FIGS. 58-60, once ring 570 is aligned withgroove 533 a, actuating bar 568 is retracted proximally, as indicated byarrow “H”. Distal retraction of actuating bar 568 relative to ring 570causes engagement of ring 570 with transition 568 c of actuating bar568. As discussed above, continued distal retraction of actuating bar568 relative to ring 570 causes the expansion of ring 570 within groove533 a formed in proximal end 532 a of link member 532. Receipt of ring570 within groove 533 a secures center rod 568 to link member 532.

Once secured to connection mechanism 560, end effector 500 operates inthe same manner as end effector 500. End effector 500 is removed fromconnection mechanism 560 in the reverse manner of attachment.

With reference now to FIGS. 61-70, an end effector according to stillyet another embodiment of the present disclosure is shown generally asend effector 600. End effector 600 is configured for operable engagementwith an actuation mechanism (not shown) including a connection mechanism660. As discussed above, actuation assembly 102 (FIG. 1) may be modifiedfor use with end effector 600. End effector 600 includes a connectionassembly 610 and a jaw assembly 630.

With reference to FIGS. 61, 62 and 65-70, connection assembly 610includes a tubular body 612 having a pair of distal supports 614extending distally therefrom for operable engagement with jaw assembly630. Each distal support 614 includes a slot 613 and an opening 615.Slot 613 is configured to receive a connecting pin 616 and opening 615is configured to receive a pivot pin 618. Tubular member 612 defines apair of cutouts 619 extending therethrough. Cutouts 619 correspond innumber and location to arms 663 a of a collet 663 of an outer tube 662of connection mechanism 660. As shown, tubular member 610 includes twocutouts 619 corresponding to arms 663 a of collet 663. It is envisionedthat collet 663 may have more than two arms 663 a, therefore tubularbody 612 may include more than two cutouts 619.

With reference still to FIGS. 61, 62 and 65-70, jaw assembly 630includes a link member 632, a first jaw member 640, and a second jawmember 650. Link member 632 includes a proximal end 632 a defining acavity 633. A groove 633 a is formed on an inner surface of proximal end632 a of link member 532. Link member 632 includes a substantiallyplanar distal end 632 b defining an opening 633. Each of first andsecond jaw members 640, 650 include a proximal end 640 a, 650 a having adiagonal slot 641, 651, respectively, and an opening 643, 653,respectively. A cutout 645, 655 on proximal end 640 a, 650 a,respectively, of each of first and second jaw members 640, 650,respectively, is configured to accommodate distal end 632 b of linkmember 632. A distal end 640 b of first jaw member 540 includes aplurality of teeth 646. A distal end 650 b of second jaw member 550includes a plurality of teeth 656 configured to mesh with teeth 646 offirst jaw member 640 when first and second jaw members 640, 650 engageone another.

With continued reference to 61, 62 and 65-70, first and second jawmembers 640, 650 are pivotally secured to arms 614 of tubular member 610by pivot pin 618 received through openings 643, 653 of respective firstand second jaw members 640, 650 and through openings 615 in distalsupports 614. Connecting pin 616 is received through diagonal slots 641,651 of respective first and second jaw members 640, 650, through slots613 formed in distal supports 614, and through opening 633 formed inlink member 632. Jaw assembly 630 is configured such that distaladvancement of connecting pin 616 through slots 613 of distal supports614 causes opening of jaw assembly 630.

With reference now to FIGS. 63, 64, 68 and 70, end effector 600 isconfigured for attachment to an actuation assembly (not shown) having aconnection mechanism 660. Connection mechanism 660 includes outer tube662, a center tube 664, an inner tube 666, a center rod 668, and aplurality of spheres 670. As noted above, outer tube 662 includes collet663 having a pair of arms 663 a. Each arm 663 a includes a protrusion663 b configured to be received within cutouts 619 defined by tubularmember 612. Arms 663 a are configured to flex outwardly upon receipt ofcenter tube 664 therethrough. Inner tube 666 is configured to beslidably received through center tube 664. Inner tube 666 defines aplurality of openings 667 formed circumferentially about inner tube 666spaced proximally of a distal end thereof. As shown, inner tube 666defines three openings 667 for accommodating the three spheres 670. Itis envisioned that connection mechanism 660 may have more or less thenthree spheres 670. Accordingly, inner tube 666 may define more or lessthen three openings 667. Center rod 568 is configured to be slidablyreceived through inner tube 666 and defines a plurality of longitudinalgrooves 669 configured to accommodate a portion of spheres 670. Grooves669 positioned circumferentially to align with openings 667 in innertube 666. The number of grooves 569 corresponds to the number of spheres670.

The attachment of end effector 600 to connection mechanism 660 will nowbe described with reference to FIGS. 65-70. Referring initially to FIG.60, distal end of outer tube 662 is received with tubular member 612 ofconnection assembly 610 of end effector 600 such that protrusions 663 bformed on collet arms 663 a are aligned with cutouts 619 defined bytubular member 612. Turning to FIG. 66, center tube 664 is then advanceddistally such the distal end thereof is received through collet 663 ofouter tube 662 causing collet arms 663 a to flex outwardly such thatprotrusions 663 b extend within cutouts 619. In this manner, outer tube662 is secured to tubular member 612. With reference now to FIGS. 67 and68, inner tube 566 and center rod 568 are then simultaneously advanceddistally to be received with cavity 633 formed in proximal end 632 a oflink member 632. Cavity 633 is configured such that upon completereception of the distal end of inner tube 666 and center rod 668 withincavity 633, openings 667 in inner tube 666 and slots 669 in center rod668 align with groove 633 a formed in proximal end 632 a of link member632. As shown, in this position, spheres 670 are partially receivedwithin slots 669 formed in center rod 668 and partially received withinopening 667 formed in inner tube 666. Turning to FIGS. 69 and 70, onceopenings 667 and slots 669 are aligned with groove 633 a, center rod 668is retracted proximally, as indicated by arrow “I”. Distal retraction ofcenter rod 668 relative to inner tube 666 results in spheres 670 beingejected from within slots 669. Ejection spheres 670 from slots 667pushes spheres 670 radially outward into groove 633 a formed in proximalend 632 a of link member 632. Receipt of spheres 670 within groove 633 asecures inner tube 666 to link member 632.

Once secured to connection mechanism 660, end effector 600 operates in asimilar manner to the above-disclosed end effectors 600. End effector600 is removed from connection mechanism 660 in the reverse manner ofattachment.

With reference now to FIGS. 71-78, a device for positioning an endeffector within a body cavity and for facilitating attachment of endeffector with the connection mechanism of an actuation assembly showngenerally as holder 800. Although shown and described as relates to endeffector 700 and connection mechanism 760, holder 800 may be used withany of the above described end effectors and connection mechanism. It isenvisioned that holder 800 may also be modified for use with other endeffectors.

With particular reference to FIG. 75, holder 800 includes a tubular body810, a shaft 820, a capsule 830, and an actuation mechanism 840. Shaft820 includes a pair of extensions 822 on a distal end thereof.Extensions 822 taper outwardly and define a slot 821 therebetween. Eachextension 822 includes an opening 823 configured to receive a pivotmember 832 extending laterally from capsule 830. Extensions 822 arespaced apart such that capsule 830 may be pivoted relative to extensions822 when tubular body 810 is in a first or retracted position (asshown). The configuration of extensions 822 is such that distaladvancement of tubular body 810 about extensions 822 causes extensions822 to move towards one another. In this manner, extensions 822 squeezecapsule 830, thereby fixing the orientation of capsule 830 relative toextensions 822. Retraction of tubular body 810 relative to extension 822allows extensions 822 to return to the original spaced configured,thereby loosening the hold on capsule 830 and permitting pivoting ofcapsule 830 relative to extensions 822.

Capsule 830 includes a cylindrical body having a substantially C-shapedcross-section configured to selectively retain end effector 700, or anyother similarly sized end effector. As noted above, capsule 830 includesa pair of pivot members 832 extending laterally outward therefromconfigured to be received within openings 823 formed in extensions 822.Capsule 830 is configured such that squeezing of extensions 822constricts capsule 830 about end effector 700 to more securely retainend effector 700 therewith. In a first position (FIG. 71), capsule 830is axially aligned with tubular body 810 and shaft 820. In thisposition, holder 800 is configured to facilitate insertion of endeffector 700 into a body cavity (not shown) through an opening in thetissue, i.e., an incision or an access port. Once received within thebody cavity, capsule 830 is configured to be rotated relative to tubularbody 810 and shaft 820 between one or more positions (FIG. 72).

The rotation of capsule 830 is achieved through the operation ofactuation mechanism 840. As shown actuation mechanism 840 includes aflexible link 842 having a distal end operative fixed to capsule 800 anda proximal end (not shown) configured for operable engagement by a userto permit retraction and advancement of link 842. As shown in FIG. 73,in a first position, link 842 is in an advanced position, therebycausing capsule 830 to assume the first or axially aligned position.Retraction of link 842 causes capsule 830 to pivot about pivot members832, thereby changing the orientation of capsule 830 relative to tubularbody 810 and shaft 820. It is envisioned that actuation mechanism 840may articulate capsule 830 through ninety degrees (90°) of articulation.

Attachment of end effector 700 to connection mechanism 760 with theassistance of holder 800 will now be described with reference to FIGS.73, 74 and 76-78. Referring initially to FIG. 73, end effector 700 isloaded into capsule 830 of holder 800. Capsule 830 is in the first oraxially aligned configuration to facilitate insertion into a body cavitythrough an incision or access port.

Turning to FIG. 74, once capsule 830, including end effector 700 hasbeen received within the body cavity, link 842 of actuation mechanism840 is retracted to cause the pivoting of capsule 830 relative to shaft820. Capsule 830 is pivoted to an orientation best suited for receivingconnection mechanism 760 (FIG. 76) within connector assembly 710 of endeffector 700.

With reference now to FIG. 77, connection mechanism 760 is then receivedwithin tubular body 712 of end effector 700. End effector 700 is thensecured to connection mechanism through operation of the actuationassembly (not shown) from which connection mechanism 760 extends. At anypoint during the connection of end effector 700 with connectionmechanism 760, tubular body 810 of holder 800 may be advanced on shaft810 to cause the approximation of extension 822, thereby causing thesqueezing of capsule 830 to more securely retain end effector 700therein to facilitate connection of end effector 700 to connectionmechanism 760.

Turning now to FIG. 78, once end effector 700 is secured to connectionmechanism 760, if tubular body 810 has been advanced relative to shaft820 to more securely retain end effector 700 within capsule 830, tubularbody 810 is retracted to release the tightened engagement of endeffector 700. Distal advancement of end effector 700 relative to capsule830 causes end effector 700 to disengage from capsule 830. Oncedisengaged, end effector 700 may be operated in any suitable manner.Capsule 830 may be returned to the first position (FIG. 71) and beremoved from within the body cavity.

It is envisioned that holder 800 may be used in the reverse order todisengage end effector 700 from connection mechanism 760 and to removeend effector 700 from within the body cavity. Holder 800 may beconfigured to be reused, or may instead be disposable.

As discussed above, the presently disclosed actuation assembly may bemodified for use with any of the above disclosed end effectors. It isenvisioned that an actuation assembly may be provided as a kit with oneor more end effectors for performing various functions. As noted above,although shown in the form of graspers for grasping tissue or otherstructure, it is envisioned that the end effectors of the presentdisclosure may instead modified for stapling, vessel sealing, andcutting. In this manner, a first end effector may be provided to performa first function and one or more end effectors may be provided toperform one or more different functions. As discussed above, theattachment and separation of the various end effectors with theactuation assembly may be accomplished within the body cavity of thepatient, i.e., without removal of the instrument from within the bodycavity.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, it isto be understood that the disclosure is not limited to those preciseembodiments, and that various other changes and modifications may beeffected therein by one skilled in the art without departing from thescope or spirit of the disclosure.

1. A system for performing an endoscopic procedure, the systemcomprising: an actuation assembly having a handle assembly and a shaftassembly; an end effector configured for selective and operativeconnection to a distal end of the shaft assembly; and a holder forselectively engaging the end effector and facilitating attachment of theend effector to the shaft assembly. 2-7. (canceled)
 8. The system ofclaim 1, wherein the handle assembly includes a trigger mechanism, aslider mechanism, a drive mechanism, and a latch mechanism, and theshaft assembly includes a connection mechanism, the connection mechanismincluding an outer tube, a center tube slidably disposed relative to theouter tube, an inner tube slidably disposed relative to the outer andcenter tubes and a center rod slidably disposed relative to outer,center, and inner tubes.
 9. The system of claim 8, further including arotation knob secured to a proximal portion of the outer tube.
 10. Thesystem of claim 8, wherein each of the outer tube, the center tube, theinner tube, and the center rod extends distally from the handleassembly.
 11. The system of claim 8, wherein the center rod includes apointed distal end.
 12. The system of claim 11, wherein the pointeddistal end is configured to penetrate tissue.
 13. The system of claim 1,wherein the shaft assembly of the actuation assembly includes across-section having a first diameter and the end effector includes across-section having a second diameter, wherein the second diameter isgreater than the first diameter.
 14. The system of claim 13, wherein thefirst diameter is dimensioned to be received through a 3 mm opening andthe second diameter is dimensioned to be received through a 5 mmopening.
 15. The system of claim 1, wherein the end effector includes aconnection assembly and a jaw assembly, the connection assembly includesa tubular body having a pair of distal supports extending distallytherefrom for operable engagement with a jaw assembly.
 16. The system ofclaim 1, wherein the holder includes a tubular body, a shaft, a capsule,and an actuation mechanism.
 17. The system of claim 16, wherein theshaft includes a distal portion and first and second extensions on thedistal portion.
 18. The system of claim 17, wherein the first and secondextensions taper outwardly and define a slot between the first andsecond extensions.
 19. The system of claim 18, wherein the capsuleincludes a cylindrical body having a substantially C-shapedcross-section configured to selectively retain the end effector.
 20. Thesystem of claim 19, wherein the capsule is pivotally secured to thefirst and second extensions.
 21. The system of claim 20, wherein thecapsule is configured to constrict about the end effector when the endeffector is received within the cylindrical body.
 22. The system ofclaim 20, wherein the capsule is movable between a first position inwhich the capsule is axially aligned with the tubular body and theshaft, and a second position in which the capsule is at an anglerelative to the tubular body and the shaft.
 23. The system of claim 22,wherein the actuation mechanism includes a link operably fixed to thecapsule, wherein movement of the link causes corresponding movement ofthe capsule.
 24. The system of claim 22, wherein the capsule is movablethrough ninety degrees of articulation.
 25. The system of claim 1,wherein the handle assembly of the actuation assembly includes a basemember, the base member including a handle portion and a distalextension.